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Peer-reviewedCC BY-NC-ND 4.0BMC Geriatrics

Persistently elevated TyG index trajectories and all-cause mortality risk in elderly adults in southwestern China: a prospective cohort study

  • Zhi Lei1
  • Liangchuan Zhang2
  • Zifang Zhou3
  • Tianyong Wu1
  • Jinlei Qi3
  • Lin Lin3
  • Chen Hang1
  • Peng Yin3
  • Zhuo Wang4
4 affiliations
  1. 1Department of Chronic Disease Control and Prevention, Luzhou Center for Disease Control and Prevention, Luzhou, China
  2. 2Department Infectious Disease Control and Prevention, Bazhong Center for Disease Control and Prevention, Bazhong, China
  3. 3National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
  4. 4Department of Chronic Disease Control and Prevention, Sichuan Provincial Center for Disease Control and Prevention, Chengdu, China
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Abstract

Background: Although previous studies have explored the association between the triglyceride-glucose (TyG) index and its trajectory with all-cause mortality in older adults, few have validated these associations specifically in the elderly population of southwestern China.

Methods: This community-based prospective cohort study included 163,315 adults aged ≥ 65 years in Luzhou City, southwestern China. Participants were enrolled from the Luzhou Universal Preventive Health Examination Program between 2017 and 2024. TyG index trajectories from 2017 to 2019 were identified using Group-Based Trajectory Modeling (GBTM). Follow-up began from the end of physical examination for each study subject in 2019 and continue until December 31, 2024. Mortality data were collected to determine participants’ vital status. Multivariable Cox proportional hazards models, including restricted cubic splines (RCS), were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality.

Results: The median follow-up time was 68.17 months, with 27,721 participants dying during the follow-up period. When the 2019 TyG index was divided into quartiles, after adjusting for confounding factors, the second quartile (Q2, HR: 1.00, 95%CI: 0.97–1.04, P = 0.913) and third quartile (Q3, HR: 0.99, 95%CI: 0.96–1.03, P = 0.694) were not associated with an increased risk of all-cause mortality compared with the first quartile (Q1). However, the fourth quartile(Q4, HR: 1.07, 95%CI: 1.03–1.11, P < 0.001) showed a significantly elevated risk. Results from RCS indicated a similar trend (p for trend < 0.001). Four distinct trajectories of the TyG index were identified: low-growth (n = 42,909, 26.27%), low-stability (n = 86,249, 52.81%), medium-stability (n = 26,727, 16.37%), and high-stability (n = 7,430, 4.55%). Compared with the low-growth group, the risk of all-cause mortality in the low-stability group, medium-stability group, and high-stability group was 0.98 (95% CI: 0.94–1.01), 1.09 (95% CI: 1.05–1.13), and 1.24 (95% CI: 1.18–1.31), respectively.

Conclusion: This study highlights that both a high baseline TyG index and a persistently elevated TyG trajectory are strongly associated with increased all cause mortality among older adults in southwestern China. Regular health check-ups and early interventions targeting elevated TyG levels may help promote longevity and improve health outcomes in this population.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08029-x.

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Cite

BibTeXRIS
BibTeX
@article{lei2026persistently,
  title = {{Persistently elevated TyG index trajectories and all-cause mortality risk in elderly adults in southwestern China: a prospective cohort study}},
  author = {Zhi Lei and Liangchuan Zhang and Zifang Zhou and Tianyong Wu and Jinlei Qi and Lin Lin and Chen Hang and Peng Yin and Zhuo Wang},
  journal = {BMC Geriatrics},
  year = {2026},
  month = aug,
  doi = {10.1186/s12877-026-08029-x},
  url = {https://doi.org/10.1186/s12877-026-08029-x},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Persistently elevated TyG index trajectories and all-cause mortality risk in elderly adults in southwestern China: a prospective cohort study
AU  - Zhi Lei
AU  - Liangchuan Zhang
AU  - Zifang Zhou
AU  - Tianyong Wu
AU  - Jinlei Qi
AU  - Lin Lin
AU  - Chen Hang
AU  - Peng Yin
AU  - Zhuo Wang
PY  - 2026
DA  - 2026/08/08
JO  - BMC Geriatrics
DO  - 10.1186/s12877-026-08029-x
UR  - https://doi.org/10.1186/s12877-026-08029-x
AB  - Background: Although previous studies have explored the association between the triglyceride-glucose (TyG) index and its trajectory with all-cause mortality in older adults, few have validated these associations specifically in the elderly population of southwestern China.  Methods: This community-based prospective cohort study included 163,315 adults aged ≥ 65 years in Luzhou City, southwestern China. Participants were enrolled from the Luzhou Universal Preventive Health Examination Program between 2017 and 2024. TyG index trajectories from 2017 to 2019 were identified using Group-Based Trajectory Modeling (GBTM). Follow-up began from the end of physical examination for each study subject in 2019 and continue until December 31, 2024. Mortality data were collected to determine participants’ vital status. Multivariable Cox proportional hazards models, including restricted cubic splines (RCS), were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause mortality.  Results: The median follow-up time was 68.17 months, with 27,721 participants dying during the follow-up period. When the 2019 TyG index was divided into quartiles, after adjusting for confounding factors, the second quartile (Q2, HR: 1.00, 95%CI: 0.97–1.04, P = 0.913) and third quartile (Q3, HR: 0.99, 95%CI: 0.96–1.03, P = 0.694) were not associated with an increased risk of all-cause mortality compared with the first quartile (Q1). However, the fourth quartile(Q4, HR: 1.07, 95%CI: 1.03–1.11, P < 0.001) showed a significantly elevated risk. Results from RCS indicated a similar trend (p for trend < 0.001). Four distinct trajectories of the TyG index were identified: low-growth (n = 42,909, 26.27%), low-stability (n = 86,249, 52.81%), medium-stability (n = 26,727, 16.37%), and high-stability (n = 7,430, 4.55%). Compared with the low-growth group, the risk of all-cause mortality in the low-stability group, medium-stability group, and high-stability group was 0.98 (95% CI: 0.94–1.01), 1.09 (95% CI: 1.05–1.13), and 1.24 (95% CI: 1.18–1.31), respectively.  Conclusion: This study highlights that both a high baseline TyG index and a persistently elevated TyG trajectory are strongly associated with increased all cause mortality among older adults in southwestern China. Regular health check-ups and early interventions targeting elevated TyG levels may help promote longevity and improve health outcomes in this population.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12877-026-08029-x.
SN  - 1471-2318
ER  -